Hospitals with dominant market share, where no insurer does, have leverage. No question. But. The first step in health care economics is the plan someone chooses. That plan sets the parameters and economics for every care choice the member can make. The very fact that patients can not shop for the best price and apply it to their deductible, or they can not afford their deductible , even in markets dominated by a system or two, shows where the leverage truly is Plus the insurance companies control ALL the patient economics once care starts. Which is huge leverage They ULCD Underpay Late Pay Claw Back Deny That distorts the entire healthcare economic system Yes , hospitals join in the fuckery, by doing shit like facilities fees , 340b abuse, Charge master arbitrage and abuse. And more. Yes. But they don’t control the cash. When hospitals and all providers grow their direct contracting businesses , see http://costpluswellness.com , you will see prices come down. So bottome line , take the big insurance companies out of the mix, hospital prices come down. It’s all right there on http://costpluswellness.com(Mark Cuban)